Skip to main content
Erschienen in: International Journal of Computer Assisted Radiology and Surgery 11/2018

24.07.2018 | Original Article

AR in VR: assessing surgical augmented reality visualizations in a steerable virtual reality environment

verfasst von: Julian Hettig, Sandy Engelhardt, Christian Hansen, Gabriel Mistelbauer

Erschienen in: International Journal of Computer Assisted Radiology and Surgery | Ausgabe 11/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose 

Augmented reality (AR) has emerged as a promising approach to support surgeries; however, its application in real world scenarios is still very limited. Besides sophisticated registration tasks that need to be solved, surgical AR visualizations have not been studied in a standardized and comparative manner. To foster the development of future AR applications, a steerable framework is urgently needed to rapidly evaluate new visualization techniques, explore their individual parameter spaces and define relevant application scenarios.

Methods 

Inspired by its beneficial usage in the automotive industry, the underlying concept of virtual reality (VR) is capable of transforming complex real environments into controllable virtual ones. We present an interactive VR framework, called Augmented Visualization Box (AVB), in which visualizations for AR can be systematically investigated without explicitly performing an error-prone registration. As use case, a virtual laparoscopic scenario with anatomical surface models was created in a computer game engine. In a study with eleven surgeons, we analyzed this VR setting under different environmental factors and its applicability for a quantitative assessment of different AR overlay concepts.

Results 

According to the surgeons, the visual impression of the VR scene is mostly influenced by 2D surface details and lighting conditions. The AR evaluation shows that, depending on the visualization used and its capability to encode depth, 37% to 91% of the experts made wrong decisions, but were convinced of their correctness. These results show that surgeons have more confidence in their decisions, although they are wrong, when supported by AR visualizations.

Conclusion 

With AVB, intraoperative situations are realistically simulated to quantitatively benchmark current AR overlay methods. Successful surgical task execution in an AR system can only be facilitated if visualizations are customized toward the surgical task.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Amir-Khalili A, Nosrati MS, Peyrat JM, Hamarneh G, Abugharbieh R (2013) Uncertainty-encoded augmented reality for robot-assisted partial nephrectomy: a phantom study. In: Augmented reality environments for medical imaging and computer-assisted interventions, Springer, pp 182–191 Amir-Khalili A, Nosrati MS, Peyrat JM, Hamarneh G, Abugharbieh R (2013) Uncertainty-encoded augmented reality for robot-assisted partial nephrectomy: a phantom study. In: Augmented reality environments for medical imaging and computer-assisted interventions, Springer, pp 182–191
2.
Zurück zum Zitat Bernhardt S, Nicolau SA, Soler L, Doignon C (2017) The status of augmented reality in laparoscopic surgery as of 2016. Med Image Anal 37:66–90CrossRefPubMed Bernhardt S, Nicolau SA, Soler L, Doignon C (2017) The status of augmented reality in laparoscopic surgery as of 2016. Med Image Anal 37:66–90CrossRefPubMed
3.
Zurück zum Zitat Bichlmeier C, Sielhorst T, Heining SM, Navab N (2007) Improving depth perception in medical ar. In: Bildverarbeitung für die Medizin 2007, Springer, pp 217–221 Bichlmeier C, Sielhorst T, Heining SM, Navab N (2007) Improving depth perception in medical ar. In: Bildverarbeitung für die Medizin 2007, Springer, pp 217–221
4.
Zurück zum Zitat Dixon BJ, Daly MJ, Chan H, Vescan AD, Witterick IJ, Irish JC (2013) Surgeons blinded by enhanced navigation: the effect of augmented reality on attention. Surg Endosc 27(2):454–461CrossRefPubMed Dixon BJ, Daly MJ, Chan H, Vescan AD, Witterick IJ, Irish JC (2013) Surgeons blinded by enhanced navigation: the effect of augmented reality on attention. Surg Endosc 27(2):454–461CrossRefPubMed
5.
Zurück zum Zitat Elhelw M, Nicolaou M, Chung A, Yang GZ, Atkins MS (2008) A gaze-based study for investigating the perception of visual realism in simulated scenes. ACM Trans Appl Percept 5(1):3:1–3:20CrossRef Elhelw M, Nicolaou M, Chung A, Yang GZ, Atkins MS (2008) A gaze-based study for investigating the perception of visual realism in simulated scenes. ACM Trans Appl Percept 5(1):3:1–3:20CrossRef
6.
Zurück zum Zitat Hansen C, Wieferich J, Ritter F, Rieder C, Peitgen HO (2010) Illustrative visualization of 3d planning models for augmented reality in liver surgery. Int J Comput Assist Radiol Surg 5(2):133–141CrossRefPubMed Hansen C, Wieferich J, Ritter F, Rieder C, Peitgen HO (2010) Illustrative visualization of 3d planning models for augmented reality in liver surgery. Int J Comput Assist Radiol Surg 5(2):133–141CrossRefPubMed
7.
Zurück zum Zitat Katić D, Wekerle AL, Görtler J, Spengler P, Bodenstedt S, Röhl S, Suwelack S, Kenngott HG, Wagner M, Müller-Stich BP, Dillmann R, Speidel S (2013) Context-aware augmented reality in laparoscopic surgery. Comput Med Imaging Graph 37(2):174–182CrossRefPubMed Katić D, Wekerle AL, Görtler J, Spengler P, Bodenstedt S, Röhl S, Suwelack S, Kenngott HG, Wagner M, Müller-Stich BP, Dillmann R, Speidel S (2013) Context-aware augmented reality in laparoscopic surgery. Comput Med Imaging Graph 37(2):174–182CrossRefPubMed
8.
Zurück zum Zitat Kersten-Oertel M, Jannin P, Collins DL (2013) The state of the art of visualization in mixed reality image guided surgery. Comput Med Imaging Graph 37(2):98–112 (special Issue on Mixed Reality Guidance of Therapy - Towards Clinical Implementation)CrossRefPubMed Kersten-Oertel M, Jannin P, Collins DL (2013) The state of the art of visualization in mixed reality image guided surgery. Comput Med Imaging Graph 37(2):98–112 (special Issue on Mixed Reality Guidance of Therapy - Towards Clinical Implementation)CrossRefPubMed
9.
Zurück zum Zitat Lerotic M, Chung AJ, Mylonas G, Yang GZ (2007) pq-space based non-photorealistic rendering for augmented reality. In: Ayache N, Ourselin S, Maeder A (eds) Medical image computing and computer-assisted intervention—MICCAI 2007, pp 102–109 Lerotic M, Chung AJ, Mylonas G, Yang GZ (2007) pq-space based non-photorealistic rendering for augmented reality. In: Ayache N, Ourselin S, Maeder A (eds) Medical image computing and computer-assisted intervention—MICCAI 2007, pp 102–109
10.
Zurück zum Zitat Medenica Z, Kun AL, Paek T, Palinko O (2011) Augmented reality versus street views: a driving simulator study comparing two emerging navigation aids. In: Proceedings of the 13th international conference on human computer interaction with mobile devices and services, ACM, New York, NY, USA, MobileHCI ’11, pp 265–274 Medenica Z, Kun AL, Paek T, Palinko O (2011) Augmented reality versus street views: a driving simulator study comparing two emerging navigation aids. In: Proceedings of the 13th international conference on human computer interaction with mobile devices and services, ACM, New York, NY, USA, MobileHCI ’11, pp 265–274
11.
Zurück zum Zitat Nicolaou M, James A, Lo BPL, Darzi A, Yang GZ (2005) Invisible shadow for navigation and planning in minimal invasive surgery. In: Duncan JS, Gerig G (eds) Medical image computing and computer-assisted intervention—MICCAI 2005, pp 25–32 Nicolaou M, James A, Lo BPL, Darzi A, Yang GZ (2005) Invisible shadow for navigation and planning in minimal invasive surgery. In: Duncan JS, Gerig G (eds) Medical image computing and computer-assisted intervention—MICCAI 2005, pp 25–32
12.
Zurück zum Zitat Pfeiffer M, Kenngott H, Preukschas A, Huber M, Bettscheider L, Müller-Stich B, Speidel S (2018) Imhotep: virtual reality framework for surgical applications. Int J Comput Assist Radiol Surg 13:741–748CrossRefPubMed Pfeiffer M, Kenngott H, Preukschas A, Huber M, Bettscheider L, Müller-Stich B, Speidel S (2018) Imhotep: virtual reality framework for surgical applications. Int J Comput Assist Radiol Surg 13:741–748CrossRefPubMed
13.
Zurück zum Zitat Tiefenbacher P, Lehment NH, Rigoll G (2014) Augmented reality evaluation: a concept utilizing virtual reality. Springer International Publishing, Cham, pp 226–236 Tiefenbacher P, Lehment NH, Rigoll G (2014) Augmented reality evaluation: a concept utilizing virtual reality. Springer International Publishing, Cham, pp 226–236
14.
Zurück zum Zitat Wild E, Teber D, Schmid D, Simpfendörfer T, Müller M, Baranski AC, Kenngott H, Kopka K, Maier-Hein L (2016) Robust augmented reality guidance with fluorescent markers in laparoscopic surgery. Int J Comput Assist Radiol Surg 11(6):899–907CrossRefPubMed Wild E, Teber D, Schmid D, Simpfendörfer T, Müller M, Baranski AC, Kenngott H, Kopka K, Maier-Hein L (2016) Robust augmented reality guidance with fluorescent markers in laparoscopic surgery. Int J Comput Assist Radiol Surg 11(6):899–907CrossRefPubMed
15.
Zurück zum Zitat Yiannakopoulou E, Nikiteas N, Perrea D, Tsigris C (2015) Virtual reality simulators and training in laparoscopic surgery. Int J Surg 13:60–64CrossRef Yiannakopoulou E, Nikiteas N, Perrea D, Tsigris C (2015) Virtual reality simulators and training in laparoscopic surgery. Int J Surg 13:60–64CrossRef
Metadaten
Titel
AR in VR: assessing surgical augmented reality visualizations in a steerable virtual reality environment
verfasst von
Julian Hettig
Sandy Engelhardt
Christian Hansen
Gabriel Mistelbauer
Publikationsdatum
24.07.2018
Verlag
Springer International Publishing
Erschienen in
International Journal of Computer Assisted Radiology and Surgery / Ausgabe 11/2018
Print ISSN: 1861-6410
Elektronische ISSN: 1861-6429
DOI
https://doi.org/10.1007/s11548-018-1825-4

Weitere Artikel der Ausgabe 11/2018

International Journal of Computer Assisted Radiology and Surgery 11/2018 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.